Korean J Anesthesiol.  2002 Jul;43(1):38-43. 10.4097/kjae.2002.43.1.38.

Effect of Propofol Anesthesia on Blood Coagulation and Fibrinolysis: An Assessment Using Thromboelastograph at Clipping of Cerebral Aneurysms

• Kim YJ
• Song DH
• Kim JH
• Cheong SH
• Choe YK
• Park JW
• Shin CM
• Park JY

• KMID: 1936032
• DOI: http://doi.org/10.4097/kjae.2002.43.1.38

Abstract

BACKGROUND: Propofol may cause perioperative bleeding because it has an inhibitory effect on platelet aggregation and an accelerative effect on blood fibrinolysis in vitro. The aim of this study was to evaluate the perioperative effect of propofol anesthesia on blood coagulation and fibrinolysis with a thromboelastograph in patients undergoing clipping of cerebral aneurysms.
METHODS
Fifteen patients who had cerebral aneurysms and no history of coagulation disorders were studied. Anesthesia was induced with a target controlled infusion of propofol to reach a calculated target blood concentration of 5ng/ml, and in addition, fentanyl 2ng/kg, lidocaine 1 mg/kg, esmolol 0.3 mg/kg and vecuronium 0.1 mg/kg were given intravenously. Anesthesia was maintained by propofol at target concentrations of 3 - 5ng/ml with nitrous oxide (67%) and oxygen (33%). The hemoglobin concentration, platelet count and a thromboelastogram were measured at before, during and after anesthesia.
RESULTS
There was no significant difference in the perioperative hemoglobin concentration and platelet count. In terms of the thromboelastogram, r time (reaction time for clot formation) and k time (clot formation time) during and after anesthesia were shorter than those before anesthesia (P < 0.05), the alpha angle (rate of clot growth) during and after anesthesia was increased more than that before anesthesia (P < 0.05), and there was no significant difference in the perioperative fibrinolytic index.
CONCLUSIONS
These results indicate that propofol anesthesia has no effect on anticoagulation and fibrinolysis in patients undergoing clipping of cerebral aneurysms in terms of the thromboelastogram, whereas, it showed a perioperative hypercoagulability. Therefore a clinical dosage of propofol may be used for neurosurgery without inhibition of coagulation.

Keyword

Blood coagulation; cerebral aneurysm; fibrinolysis; propofol; thromboelastograph

MeSH Terms

Anesthesia*
Blood Coagulation*
Fentanyl
Fibrinolysis*
Hemorrhage
Humans
Intracranial Aneurysm*
Lidocaine
Neurosurgery
Nitrous Oxide
Oxygen
Platelet Aggregation
Platelet Count
Propofol*
Thrombophilia
Vecuronium Bromide
Fentanyl
Lidocaine
Nitrous Oxide
Oxygen
Propofol
Vecuronium Bromide